Support the work of community-based organizations in demanding for better health services and accountability from government and other duty bearers

Support Our Work

MOTIVATION FOR OUR WORK

Primary Health Care is still a major development challenge in Nigeria. It is strongly believed that if Nigeria can achieve its PHC targets, it would have solved most of its health problems including maternal and child mortality problem. It is a fact that most documented maternal and child mortality incidences occur in the community PHCs. Maternal and child mortality rate are still unacceptably high among communities in Northern Nigeria. In terms of the actual number of maternal deaths, Nigeria is ranked second in the world behind India.

Burdened with some of the highest maternal mortality and child morbidity rates in the world, northern Nigeria’s efforts to improve health services are continually undermined by structural and institutional weaknesses. Fragmentation of the health sector, inclusive of management of staff, funds, and other resources has been the most significant intractable problem facing the country’s primary health care (PHC) services. Accountability mechanisms are weak and the quality of health services suffer. Communities have little confidence in services provided and utilization is usually very low.

The Maternal Mortality Rate in Northern Nigeria is worse than the national Average at 1,025 per 100,000 live births compared to the national average of 800 per 100, 000 live births. The predominantly Muslim Northwest states continue to lag behind in educational and health-related indices. According to a report from the British Council Nigeria 2012, over two-thirds of girls in the North aged 15-19 years are unable to read compared to less than 10% in the South; in the North, only 3% complete secondary school and more than 50% are married by age 16. Early marriages exacerbate the problem of maternal mortality in the zone.

In Katsina State, only 14% of pregnant women attend at least one antenatal care clinic with skilled personnel (the recommended number of attendance is 4), while skilled birth attendant coverage during delivery and postnatal periods were only 7.4% and 1% respectively. Most cases that contribute to high rate of maternal and child mortality in Nigeria occur in Northern Nigeria due to causes ranging from high fertility rate, poor maternal health care (including ante-natal and post-natal care) negative cultural practices like early marriage, high rate of poverty, limited knowledge on the importance of immunization etc.

It is also a fact that this problem continues to endure simply due to lack of political will to address them; which is further reinforced by community inability to demand accountability from political office holders who are primary duty bearers and do not deem it important or constrained to fulfill the promises made based on the aspirations of the people.

OUR INTERVENTION

Advocacy

We aim to use evidence to advocate for better health policy choices on maternal, Newborn and Child Health (MNCH); translating best policy choices into appropriate legislation and regulations in health care delivery systems of Northern Nigeria.

We will achieve this through demonstrated advocacy. We want to demonstrate that if PHCs are well equipped with the right equipment and manpower and host communities are mobilized to demand, and access MNCH services in their PHCs, maternal and child mortality rates can decline considerably within a space of one year.

Model PHC Centers

We, therefore, will work through “model communities” in Northern Nigeria where we will select model PHC centers, get them equipped, train and retrain staff as needed. We will observe and document progress and improvement in specific areas of Maternal and Child Mortality rates for one year in the model community PHCs using other communities as control communities. Evidential findings will be used as advocacy tools to the government to provide better MNCH services for citizens.

Our Goal

With your help, we will adopt and equip 15 PHCs in at least 10 communities where regular Routine Immunization, Antenatal, skilled birth attendance and postnatal services will be provided for rural women and children for 12 months.

Collaboration and Advocacy

We will also open up spaces for networking and collaborative support among community-based non-state actors to expand their scope of engagement with health services providers to include demand for accountability and transparency in health spending at the primary health care level. The capacity of Community Health Committees (CHCs) otherwise known as HOSPITAL FRIENDS Forum will be enhanced concurrently to respond to emerging demands and expectations of organized CBO demands. CHCs will lead processes of community and stakeholder engagements given their nature of inter-phasing between the community and government; on one side, creating demand for services and on the other advocating for improved service delivery from duty bearers. Importantly, all the time ensuring the flow of well-articulated information from one side to the other.

Capacity Building

Capacity will be built and awareness created around policies like the Freedom of Information Act (FOI), procurement act, and state policy on free maternal and child health care, budgetary allocations to PHC, the National Health Insurance Scheme (NHIS) and various other state-level policies on Primary health Care as tools for demanding accountability.